MRI on Lumbar Spine

MRI on Lumbar Spine

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Anonymous (not verified)
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MRI on Lumbar Spine

Hello. I am new to this board and find it very knowledgeable. Wondering if any one can help me with this MRI diagnosis in non doctor terms. I hurt my back lifting something and I've had chronic pain for the past 3 weeks shooting down the left side of my buttocks and leg. They said there was no disc herniation but slight bulging. Does anyone know how long I'll feel like this? Here i my MRI results.

FINDINGS- Evaluation is slightly limited secondary to motion artifact. For numbering purposes it will be assumed that there are five lumbar vertebrae. The conus terminates at the T12-L1 level and is incompletely imaged. There is no fracture of bone marrow edema. There is a decrease in the AP diameter of the spinal canal suggestive of congenital central spinal stenosis. Multilevel Schmorl's nodes are identified. There is desiccation of the L5-S1 disc.

L1-L2 - There is mild disc bulging causing mild impression on the anterior thecal sac. The neural foramina are patent.

L2-L3 - There is no disc herniation. The neural foramina are patent.

L3-L4 - There is no disc herniation. The neural foramina are patent.

L4-L5 - There is mild diffuse disc bulging with suggestion of a small superimposed central disc protrusion which causes minimal impression on the anterior thecal sac. There is minimal bilateral neural foraminal narrowing.

L5-S1 - There is mild diffuse disc bulging with suggestion of a small superimposed central disc protrusion which causes minimal impression on the anterior thecal sac. There is facet anthrosis bilaterally. There is severe left and moderately severe right neural foraminal narrowing.

CONCLUSION - Degenerative disc disease at L5-S1. Congenitally narrow spinal canal. Small central disc protrusions at L4-L5 and L5-S1.

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balou2 (not verified)
Title: Member
Hello Rob! Welcome to the


The information provided by members of Spine-Health should never be considered as formal medical advice. It is recommendations based on member's personal experiences only.
This can vary from person to person, so do not take comments as medical rules....Edited by moderator Paulgla

Hello Rob!
Welcome to the board. Here's what I see:

Quote:
L1-L2 - There is mild disc bulging causing mild impression on the anterior thecal sac. The neural foramina are patent.

So, the thecal sac is located within the spinal canal and contains the spinal cord, cauda equina (collection of nerve roots at the end of the spinal cord), and CSF (spinal fluid). You may have pain radiating into the left hip which is common with effect upon the sac as it is basically a tube that holds the spine and spinal fluid. Mild bulging could cause discomfort, but not in your legs...not at least from L1/L2 - that's too high. "Neural foramina" means "nerve hole." The neural foramina is the hole through which nerves leave the spinal cord and radiate out of the spine to the body. Narrowing of the hole through which the nerve passes causes pain, tingling, weakness, etc., in the locations those nerves meet. "Neural foramina patent" just means that the openings in the spine are open, and allow the nerves to pass through normally. The upper lumbar region (L1, L2 and L3) controls the psoas muscles, which could cause pain or discomfort in your belly, lower abdomen, hip and thigh. So...basically, while you may have some pressure going on, there should be no issues (yet) with this level.

Quote:
L2-L3 - There is no disc herniation. The neural foramina are patent.

Good for you!!! No disc problems, and holes for your nerves are open and in dynamite shape. Have a beer!

Quote:
L3-L4 - There is no disc herniation. The neural foramina are patent.

Good for you!!! No disc problems, and holes for your nerves are open and in dynamite shape. Have another beer!

Quote:
L4-L5 - There is mild diffuse disc bulging with suggestion of a small superimposed central disc protrusion which causes minimal impression on the anterior thecal sac. There is minimal bilateral neural foraminal narrowing

So, now take what we said above, and apply it to this. Here are where your problems begin, but this is nothing too serious. Your have a disc bulge on the front of your thecal sac (here is where your buttox pain starts). The "minimal neural foraminal narrowing" is a common trait in L4-5 annular disc bulging. This means there is less room for the nerves to go through in order to get to the leg. This is among the most COMMON reasons for pain in the leg. In other words, the pain you're feeling in the leg is starting here.

Quote:
L5-S1 - There is mild diffuse disc bulging with suggestion of a small superimposed central disc protrusion which causes minimal impression on the anterior thecal sac. There is facet anthrosis bilaterally. There is severe left and moderately severe right neural foraminal narrowing.

So, similar to the L4-5, but worse. The annulus (outer disc) may bulge or protrude in a small discreet area called a "focal" disc bulge or it may bulge across a wide portion of the disc, which would be called a "diffuse" bulge. This is the pressure on the thecal sac. Bilateral facet anthrosis is another cause for pain. The wear and tear or degeneration that can occur in a joint is often referred to as arthrosis. The facet joints in the back part of the spine, which are joints that normally have a smooth cartilage surface, can wear out. While the disc is the cushion in the front, the facet joints in the back part of the spine glide over each other as the spine moves, with the center of rotation in the region of the disc. In other words, think of the cartilage in your knee tearing, or wearing out, and how that would feel...except imagine it in your back. We already described foraminal narrowing, which you have noted as "severe". This is why you would have pain further down your leg, and possibly in to your foot.

So...all in all, you've got some stuff going on back there that is definitely causing pain, but nothing that most physicians would operate on. A very "general" rule of thumb is that disc herniations do not reach surgical needs until no less than 3-4mm, or with other complications involved.

A couple of general notes from the "FINDINGS":
Schmorl's Nodes are protrusions of disc material into the surface of the vertebral body, which may contact the marrow of the vertebra and lead to inflammation. They often happen due to trauma in the back, like you mentioned above. They are almost never an operable type of thing, but require rest, some possible chiropractic/spinal manipulation, and then gradual return to full work. Sometimes they never go away, but they won't be the cause for the pain you're feeling now. Anti-inflammatories could help this.

There is also a mention that "suggests" stenosis. Stenosis is the narrowing of the spinal canal. In this case, the "FINDINGS" are vague enough that I doubt there is cause for immediate concern. If so, there would likely be a notation of distance (i.e. in millimeters). The diameter of the normal lumbar spinal canal varies from 15 to 27 mm. Lumbar stenosis results from a spinal canal diameter of less than 12 mm, according to my readings, though it is most dependent on the size of whatcha' got! If your nerves are bigger than usual, then stenosis may be diagnosed at 15mm. This may or may not be a permanent thing, as it could be caused due to the facet joint issues we mentioned above. Again, at this point, the stenosis is likely not causing your major issues. Some 60% of all people have some sort of spinal stenosis at some point on their spine.

Please note, I am not a doctor, just a long time lumbar butcher's project, having had 5 surgeries (my 5th, a reconstruction at L3-4, last week). Here are my recommendations for you:

- Ask your doctor about cortisone injections. This could help with the neural foraminal narrowing and inflamation caused by everything going on in there. They never worked for me, but your issues are not quite as serious.
- Begin some physical therapy if you are able.
- Body mechanics and spine-neutral positions are important. Read up on these: how to properly turn and twist, sitting at a desk etc.... It all sounds simple, and really is, the hard part is the discipline in remembering it with every breath you take.
- Begin building your core strength - abdomen, lower back muscles etc... I wouldn't recommend crunches or anything so invasive, but you can tighten your abdominal muscles with just about every movement you take.
- If you're not doing so already, begin taking an anti-inflammatory. 800mg Motrin can be a place to start, or get a stronger one from your doc.
- BE CAUTIOUS of your movements and activities! I'm not telling you to live in a bubble, but the report above signifies a very real possibility that herniations are in your future. Good body mechanics and core exercises will help with this.
- Drink beer.

I hope this does the translation you needed. If you need anything more, PM me directly.

Best of luck,
Mike in Los Gatos.

meydey321
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HI Mike

That is excellent work, as usual Smile

Hi Rob, welcome to Spine Health. I can't think of anything else to add, Mike covered it all perfectly. I hope you get well soon. Wave

Rob Mc (not verified)
Title: Member
mri

WOW Mike. Your not a doctor? HAHA. Thanks for putting it in normal peoples terms. I appreciate it alot and you helped me in these findings. Ive been like this for 3weeks, out of work on workmans comp. but the pain isnt getting better. Hope so soon. Thanks again Mike, and you dont have to tell me to drink beer, Im very good at it! Thanks meydey too for your kind words.

Kimbercav
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Slight bulging disc, L2, L3

L2

dilauro
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That answer

can only come from your doctor. It is impossible for anyone here to give you a reliable medical answer.

Ron DiLauro Spine-Health System Moderator
Dont laugh at me

eten
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Hey Mike,

EDITED POST by Sandi- asking for or providing an opinion or interpretation of medical test results is NOT permitted on Spibe-Health.
Spine Health reserves the right to edit or delete any post that is in violation of the forum rules and guidelines. Please see the link below for more information.http://www.spine-health.com/forum/announcements/spine-health-announcemen...

Appreciate it

-E.

sandi
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Eten

As you were already advised, none of us is qualfied to give you an opinion on your MRI. It is a violation of the forum rules to ask for or to give an opinion on anyone's test results including MRI's and CT scans.

You agree not to ask for any analysis or interpretation of diagnostic tests (ie MRI, CTScans, EMG, etc.),

You agree not to respond to any request for analysis of diagnostic tests (ie MRI, CTScans, EMG, etc.)

eten
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I understand that. I am just

I understand that. I am just asking for a recommendation based on a member's personal experience as was done above.

rohitha
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Very helpful reply frm balou2

tnk u